年轻女性乳腺包块的X线及MRI征象分析

The analysis between X-ray and MRI of breast mass in young women

目的:分析年轻女性乳腺包块X线、MRI特点,提高影像诊断准确率。方法:回顾研究33例临床、病理证实的年轻女性乳腺单发包块患者的临床及术前X线、MRI资料。结果:全组包括原发血管肉瘤2例,浸润性导管癌17例,导管内癌微浸润7例,纤维腺瘤7例;X线征象包括肿块或结节13例,结构扭曲2例,局灶性不对称致密影7例,大片泥沙样钙化1例,细小多形性钙化2例,簇状泥沙样钙化2例,无阳性征象6例;MRI平扫+增强征象包括:结节或肿块样强化22例,局灶性片状强化3例,沿导管走行分布多发强化4例,段样强化1例,多发导管样强化2例,多发线样强化1例,曲线平台型12例,流出型15例,流入型6例。结论:X线对年轻女性乳腺内典型良性结节、表现为结构扭曲及钙化灶的乳腺癌检出及诊断价值极高,但因乳腺腺体致密,X线仍存在假阳性。MRI可敏感检出乳腺包块,结合强化特点,准确鉴别病灶良恶性价值巨大。

Objective： To improve the diagnostic accuracy by analyzing the X-ray and MRI characteristics of breast mass in young women.Methods： The clinical and image data（ included X-ray and MRI features） of 33 young women with breast mass confirmed by surgery and pathology were studied retrospectively.Results： The total group included 2 cases of primary angiosarcoma,17 cases of invasive ductal carcinoma,7 cases of intravascular cancer micro-infiltration,7 cases of fibroadenomas.The X-ray features were as follows： 13 cases of masses or nodules,structure distortion in 2 cases,7 cases of asymmetric focal dense shade,large sediment sample calcification 1 case,small pleomorphic calcification in 2 cases,clusters of sediment sample calcification in 2 cases,6 cases no positive signs.MRI features include： Nodule or mass samples strengthening in 22 cases,focal flake reinforced in 3 cases,line up the catheter to the distribution of multiple improved in 4 cases,sample reinforcement in 1 case,multiple tube sample reinforcement in 2 cases,improved in 1 case.The time signal curve（ TIC） includes： 12 cases of platform type,15 cases of outflow type,and 6 cases of inflow type.Conclusion： The X-ray is extremely valuable for typical benign nodules and breast cancer of young women,however,for dense breast,the false positive rate should not be ignored.The breast mass can be sensitively detected by MRI.Combined with MRI scanning and enhanced scanning,the diagnostic accuracy is greatly improved.